請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43684
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 湯佩芳(Pei-Fang Tang) | |
dc.contributor.author | Nai-Yu Chen | en |
dc.contributor.author | 陳乃鈺 | zh_TW |
dc.date.accessioned | 2021-06-15T02:25:57Z | - |
dc.date.available | 2009-09-15 | |
dc.date.copyright | 2009-09-15 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2009-08-18 | |
dc.identifier.citation | REFERENCES
1. Stineman MG, Maislin G, Fiedler RC, Granger CV. A prediction model for functional recovery in stroke. Stroke. 1997;28:550-556. 2. Shumway-Cook A, Woollacott M. Normal postural control. Motor control: Translating research into clinical practice. Philadelphia: Lippincott Williams and Wilkins; 2007:157-186. 3. Carr J, Shepherd R. Balance. Stroke rehabilitation: Guideline for exercise and training to optimize motor skill Philadelphia: Butterworth Heinemann; 2003:35-75. 4. Gillen G, Burkhardt A. Stroke rehabilitation : A function-based approach. St. Louis: Mosby; 2004. 5. Ryerson S, Levit K. Functional movement: A practical model for treatment. Functional movement reeducation: A contemporary model for stroke rehabilitation. New York: Churchill Livingstone; 1997:1-13. 6. Feigin L, Sharon B, Czaczkes B, Rosin AJ. Sitting equilibrium 2 weeks after a stroke can predict the walking ability after 6 months. Gerontology. 1996;42:348-353. 7. Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, Nieuwboer A, De Weerdt W. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20:451-458. 8. Benaim C, Perennou DA, Villy J, Rousseaux M, Pelissier JY. Validation of a standardized assessment of postural control in stroke patients: The postural assessment scale for stroke patients (pass). Stroke. 1999;30:1862-1868. 9. 王淳厚, 毛慧芬, 薛漪平, 謝清麟. 中風病人姿勢控制評估量表之心理計量特性. 台灣醫學. 2002;6:474-482. 10. Hsieh CL, Sheu CF, Hsueh IP, Wang CH. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke. 2002;33:2626-2630. 11. Collin C, Wade D. Assessing motor impairment after stroke: A pilot reliability study. J Neurol Neurosurg Psychiatry. 1990;53:576-579. 12. Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W. The trunk impairment scale: A new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326-334. 13. Tyson SF, Hanley M, Chillala J, Selley AB, Tallis RC. The relationship between balance, disability, and recovery after stroke: Predictive validity of the brunel balance assessment. Neurorehabil Neural Repair. 2007;21:341-346. 14. Sandin KJ, Smith BS. The measure of balance in sitting in stroke rehabilitation prognosis. Stroke. 1990;21:82-86. 15. Franchignoni FP, Tesio L, Ricupero C, Martino MT. Trunk control test as an early predictor of stroke rehabilitation outcome. Stroke. 1997;28:1382-1385. 16. Duarte E, Marco E, Muniesa JM, Belmonte R, Diaz P, Tejero M, Escalada F. Trunk control test as a functional predictor in stroke patients. J Rehabil Med. 2002;34:267-272. 17. Schuling J, de Haan R, Limburg M, Groenier KH. The frenchay activities index. Assessment of functional status in stroke patients. Stroke. 1993;24:1173-1177. 18. Verheyden G, Nieuwboer A, De Wit L, Feys H, Schuback B, Baert I, Jenni W, Schupp W, Thijs V, De Weerdt W. Trunk performance after stroke: An eye-catching predictor of functional outcome. J Neurol Neurosurg Psychiatry. 2006;78(7):694-698. 19. Collaboration SUT. Organised inpatient (stroke unit) care for stroke (cochrane review). 2001 20. Bernhardt J, Chan J, Nicola I, Collier JM. Little therapy, little physical activity: Rehabilitation within the first 14 days of organized stroke unit care. J Rehabil Med. 2007;39:43-48. 21. Smith ME, Garraway WM, Smith DL, Akhtar AJ. Therapy impact on functional outcome in a controlled trial of stroke rehabilitation. Arch Phys Med Rehabil. 1982;63:21-24. 22. Indredavik B, Bakke F, Slordahl SA, Rokseth R, Haheim LL. Treatment in a combined acute and rehabilitation stroke unit: Which aspects are most important? Stroke. 1999;30:917-923. 23. Diserens K, Michel P, Bogousslavsky J. Early mobilisation after stroke: Review of the literature. Cerebrovasc Dis. 2006;22:183-190. 24. Landi G, D'Angelo A, Boccardi E, Candelise L, Mannucci PM, Morabito A, Orazio EN. Venous thromboembolism in acute stroke. Prognostic importance of hypercoagulability. Arch Neurol. 1992;49:279-283. 25. Warlow C, Ogston D, Douglas AS. Deep venous thrombosis of the legs after strokes. Part i--incidence and predisposing factors. Br Med J. 1976;1:1178-1181. 26. Garrett VE, Scott JA, Costich J, Aubrey DL, Gross J. Bladder emptying assessment in stroke patients. Arch Phys Med Rehabil. 1989;70:41-43. 27. Darby DG, Barber PA, Gerraty RP, Desmond PM, Yang Q, Parsons M, Li T, Tress BM, Davis SM. Pathophysiological topography of acute ischemia by combined diffusion-weighted and perfusion mri. Stroke. 1999;30:2043-2052. 28. Panayiotou B, Reid J, Fotherby M, Crome P. Orthostatic haemodynamic responses in acute stroke. Postgrad Med J. 1999;75:213-218. 29. Hayes SH, Carroll SR. Early intervention care in the acute stroke patient. Arch Phys Med Rehabil. 1986;67:319-321. 30. Duncan PW, Zorowitz R, Bates B, Choi JY, Glasberg JJ, Graham GD, Katz RC, Lamberty K, Reker D. Management of adult stroke rehabilitation care: A clinical practice guideline. Stroke. 2005;36:e100-143. 31. Bates B, Choi JY, Duncan PW, Glasberg JJ, Graham GD, Katz RC, Lamberty K, Reker D, Zorowitz R. Veterans affairs/department of defense clinical practice guideline for the management of adult stroke rehabilitation care: Executive summary. Stroke. 2005;36:2049-2056. 32. Schwamm LH, Pancioli A, Acker JE, 3rd, Goldstein LB, Zorowitz RD, Shephard TJ, Moyer P, Gorman M, Johnston SC, Duncan PW, Gorelick P, Frank J, Stranne SK, Smith R, Federspiel W, Horton KB, Magnis E, Adams RJ. Recommendations for the establishment of stroke systems of care: Recommendations from the american stroke association's task force on the development of stroke systems. Stroke. 2005;36:690-703. 33. Adams HP, Jr., del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks EF. Guidelines for the early management of adults with ischemic stroke: A guideline from the american heart association/american stroke association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups: The american academy of neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655-1711. 34. Wojner-Alexander AW, Garami Z, Chernyshev OY, Alexandrov AV. Heads down: Flat positioning improves blood flow velocity in acute ischemic stroke. Neurology. 2005;64:1354-1357. 35. Frank JI. Large hemispheric infarction, deterioration, and intracranial pressure. Neurology. 1995;45:1286-1290. 36. Kwakkel G. Impact of intensity of practice after stroke: Issues for consideration. Disabil Rehabil. 2006;28:823-830. 37. Kwakkel G, Wagenaar RC, Twisk JW, Lankhorst GJ, Koetsier JC. Intensity of leg and arm training after primary middle-cerebral-artery stroke: A randomised trial. Lancet. 1999;354:191-196. 38. Kollen B, van de Port I, Lindeman E, Twisk J, Kwakkel G. Predicting improvement in gait after stroke: A longitudinal prospective study. Stroke. 2005;36:2676-2680. 39. Taub E, Miller NE, Novack TA, Cook EW, 3rd, Fleming WC, Nepomuceno CS, Connell JS, Crago JE. Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil. 1993;74:347-354. 40. Taub E, Uswatte G, Pidikiti R. Constraint-induced movement therapy: A new family of techniques with broad application to physical rehabilitation--a clinical review. J Rehabil Res Dev. 1999;36:237-251. 41. Dromerick AW, Edwards DF, Hahn M. Does the application of constraint-induced movement therapy during acute rehabilitation reduce arm impairment after ischemic stroke? Stroke. 2000;31:2984-2988. 42. Page SJ, Levine P, Leonard AC. Modified constraint-induced therapy in acute stroke: A randomized controlled pilot study. Neurorehabil Neural Repair. 2005;19:27-32. 43. Fang Y, Chen X, Li H, Lin J, Huang R, Zeng J. A study on additional early physiotherapy after stroke and factors affecting functional recovery. Clin Rehabil. 2003;17:608-617. 44. Howe TE, Taylor I, Finn P, Jones H. Lateral weight transference exercises following acute stroke: A preliminary study of clinical effectiveness. Clin Rehabil. 2005;19:45-53. 45. Pollock A, Baer GD, Langhorne P, Pomeroy VM. Physiotherapy treatment approaches for stroke. Stroke. 2008:519-520. 46. Rensink M, Schuurmans M, Lindeman E, Hafsteinsdottir T. Task-oriented training in rehabilitation after stroke: Systematic review. J Adv Nurs. 2009;65:737-754 47. Schaechter JD. Motor rehabilitation and brain plasticity after hemiparetic stroke. Prog Neurobiol. 2004;73:61-72. 48. Gordon J. Assumptions underlying physical therapy intervention: Theoretical and historical perspectives. In: Carr J, Shepherd R, eds. Movement sciences: Foundations for physical therapy in rehabilitation. Rockville: Aspen Publishers; 1987:1-30. 49. Dean CM, Shepherd RB. Task-related training improves performance of seated reaching tasks after stroke. A randomized controlled trial. Stroke. 1997;28:722-728. 50. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: A randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81:409-417. 51. Salbach NM, Mayo NE, Wood-Dauphinee S, Hanley JA, Richards CL, Cote R. A task-orientated intervention enhances walking distance and speed in the first year post stroke: A randomized controlled trial. Clin Rehabil. 2004;18:509-519. 52. Salbach NM, Mayo NE, Robichaud-Ekstrand S, Hanley JA, Richards CL, Wood-Dauphinee S. The effect of a task-oriented walking intervention on improving balance self-efficacy poststroke: A randomized, controlled trial. J Am Geriatr Soc. 2005;53:576-582. 53. Malouin F, Potvin M, Prevost J, Richards CL, Wood-Dauphinee S. Use of an intensive task-oriented gait training program in a series of patients with acute cerebrovascular accidents. Phys Ther. 1992;72:781-789; discussion 789-793. 54. Richards CL, Malouin F, Wood-Dauphinee S, Williams JI, Bouchard JP, Brunet D. Task-specific physical therapy for optimization of gait recovery in acute stroke patients. Arch Phys Med Rehabil. 1993;74:612-620. 55. 黃佳琦. 早期軀幹運動訓練促進中風患者之恢復. 國立陽明大學物理治療研究所. 2004;碩士論文:1-77. 56. Everitt B, Pickles A. Treatment allocation, the size of trials and reporting results. Statistical aspects of the design and analysis of clinical trials. London: Imperial College Press; 2004:18-36. 57. Demeurisse G, Demol O, Robaye E. Motor evaluation in vascular hemiplegia. Eur Neurol. 1980;19:382-389. 58. Cameron D, Bohannon RW. Criterion validity of lower extremity motricity index scores. Clin Rehabil. 2000;14:208-211 59. Franchignoni F, Tesio L, Benevolo E, Ottonello M. Psychometric properties of the rivermead mobility index in italian stroke rehabilitation inpatients. Clin Rehabil. 2003;17:273-282 60. Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke. 2002;33:1022-1027. 61. Holden MK, Gill KM, Magliozzi MR, Nathan J, Piehl-Baker L. Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther. 1984;64:35-40. 62. Mahoney FI, Barthel DW. Functional evaluation: The barthel index. Md State Med J. 1965;14:61-65. 63. Hsueh IP, Lee MM, Hsieh CL. Psychometric characteristics of the barthel activities of daily living index in stroke patients. J Formos Med Assoc. 2001;100:526-532. 64. van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19:604-607. 65. Banks JL, Marotta CA. Outcomes validity and reliability of the modified rankin scale: Implications for stroke clinical trials: A literature review and synthesis. Stroke. 2007;38:1091-1096. 66. Wilson JT, Hareendran A, Hendry A, Potter J, Bone I, Muir KW. Reliability of the modified rankin scale across multiple raters: Benefits of a structured interview. Stroke. 2005;36:777-781. 67. Wolfe CD, Taub NA, Woodrow EJ, Burney PG. Assessment of scales of disability and handicap for stroke patients. Stroke. 1991;22:1242-1244. 68. New PW, Buchbinder R. Critical appraisal and review of the rankin scale and its derivatives. Neuroepidemiology. 2006;26:4-15. 69. Horak F. Assumptions underlying motor control for neurologic rehabilitation. In: Lister M, ed. Contemporary management of motor control problems: Proceedings of the ii step conference. Alexandria: Foundation of Physical Therapy; 1991:11-27. 70. Mathiowetz V. Task-oriented approach to stroke rehabilitation. In: Gillen G, Burkhardt A, eds. Stroke rehabilitation: A function-based approach. 2004:59-74. 71. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med. 1970;2:92-98. 72. Noble BJ. Clinical applications of perceived exertion. Med Sci Sports Exerc. 1982;14:406-411. 73. Eng JJ, Chu KS, Dawson AS, Kim CM, Hepburn KE. Functional walk tests in individuals with stroke: Relation to perceived exertion and myocardial exertion. Stroke. 2002;33:756-761. 74. Portney LG, Watkins MP. Foundations of clinical research: Applications to practice. U.S.A.: Appleton and Lange; 1993. 75. Brott T, Adams HP, Jr., Olinger CP, Marler JR, Barsan WG, Biller J, Spilker J, Holleran R, Eberle R, Hertzberg V, et al. Measurements of acute cerebral infarction: A clinical examination scale. Stroke. 1989;20:864-870 76. Jeng JS, Huang SJ, Tang SC, Yip PK. Predictors of survival and functional outcome in acute stroke patients admitted to the stroke intensive care unit. J Neurol Sci. 2008;270:60-66 77. Arnold M, Halpern M, Meier N, Fischer U, Haefeli T, Kappeler L, Brekenfeld C, Mattle HP, Nedeltchev K. Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke. J Neurol. 2008;255:1503-1507 78. Tseng MC, Chang KC. Stroke severity and early recovery after first-ever ischemic stroke: Results of a hospital-based study in taiwan. Health Policy. 2006;79:73-78. 79. Wyller TB. Stroke and gender. J Gend Specif Med. 1999;2:41-45 80. Eriksson M, Glader EL, Norrving B, Terent A, Stegmayr B. Sex differences in stroke care and outcome in the swedish national quality register for stroke care. Stroke. 2008 81. Paolucci S, Antonucci G, Grasso MG, Bragoni M, Coiro P, De Angelis D, Fusco FR, Morelli D, Venturiero V, Troisi E, Pratesi L. Functional outcome of ischemic and hemorrhagic stroke patients after inpatient rehabilitation: A matched comparison. Stroke. 2003;34:2861-2865 82. Macciocchi SN, Diamond PT, Alves WM, Mertz T. Ischemic stroke: Relation of age, lesion location, and initial neurologic deficit to functional outcome. Arch Phys Med Rehabil. 1998;79:1255-1257 83. Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, Shephard T. Physical activity and exercise recommendations for stroke survivors: An american heart association scientific statement from the council on clinical cardiology, subcommittee on exercise, cardiac rehabilitation, and prevention; the council on cardiovascular nursing; the council on nutrition, physical activity, and metabolism; and the stroke council. Circulation. 2004;109:2031-2041 84. Adams HP, Jr., del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks EF. Guidelines for the early management of adults with ischemic stroke: A guideline from the american heart association/american stroke association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups: The american academy of neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655-1711 85. Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D, Mayberg M, Morgenstern L, Ogilvy CS, Vespa P, Zuccarello M. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: A guideline from the american heart association/american stroke association stroke council, high blood pressure research council, and the quality of care and outcomes in research interdisciplinary working group. Stroke. 2007;38:2001-2023. 86. Eng JJ, Chu KS, Kim CM, Dawson AS, Carswell A, Hepburn KE. A community-based group exercise program for persons with chronic stroke. Med Sci Sports Exerc. 2003;35:1271-1278 87. Peurala SH, Airaksinen O, Jakala P, Tarkka IM, Sivenius J. Effects of intensive gait-oriented physiotherapy during early acute phase of stroke. J Rehabil Res Dev. 2007;44:637-648. 88. Leroux A, Pinet H, Nadeau S. Task-oriented intervention in chronic stroke: Changes in clinical and laboratory measures of balance and mobility. Am J Phys Med Rehabil. 2006;85:820-830 89. McLean R. Incidence of complications in stroke patients in an acute rehabilitation unit in singapore. Cerebrovasc Dis. 2007;24:129-132. 90. Duncan PW, Goldstein LB, Horner RD, Landsman PB, Samsa GP, Matchar DB. Similar motor recovery of upper and lower extremities after stroke. Stroke. 1994;25:1181-1188 91. Verheyden G, Nieuwboer A, De Wit L, Thijs V, Dobbelaere J, Devos H, Severijns D, Vanbeveren S, De Weerdt W. Time course of trunk, arm, leg, and functional recovery after ischemic stroke. Neurorehabil Neural Repair. 2008;22:173-179 92. Bohannon RW. Recovery and correlates of trunk muscle strength after stroke. Int J Rehabil Res. 1995;18:162-167. 93. Franchignoni F. Psychometric properties and practical attributes of the trunk control test in stroke patients. J Rehabil Med. 2003;35:150; author reply 150-151 94. Verheyden G, Nieuwboer A, Van de Winckel A, De Weerdt W. Clinical tools to measure trunk performance after stroke: A systematic review of the literature. Clin Rehabil. 2007;21:387-394. 95. Lindberg P, Schmitz C, Forssberg H, Engardt M, Borg J. Effects of passive-active movement training on upper limb motor function and cortical activation in chronic patients with stroke: A pilot study. J Rehabil Med. 2004;36:117-123 96. Granger CV, Dewis LS, Peters NC, Sherwood CC, Barrett JE. Stroke rehabilitation: Analysis of repeated barthel index measures. Arch Phys Med Rehabil. 1979;60:14-17 97. Karatas M, Cetin N, Bayramoglu M, Dilek A. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil. 2004;83:81-87. 98. Desrosiers J, Malouin F, Richards C, Bourbonnais D, Rochette A, Bravo G. Comparison of changes in upper and lower extremity impairments and disabilities after stroke. Int J Rehabil Res. 2003;26:109-116 99. Sulter G, Steen C, De Keyser J. Use of the barthel index and modified rankin scale in acute stroke trials. Stroke. 1999;30:1538-1541 100. Kwakkel G, van Peppen R, Wagenaar RC, Wood Dauphinee S, Richards C, Ashburn A, Miller K, Lincoln N, Partridge C, Wellwood I, Langhorne P. Effects of augmented exercise therapy time after stroke: A meta-analysis. Stroke. 2004;35:2529-2539. 101. Baer GD, Smith MT, Rowe PJ, Masterton L. Establishing the reliability of mobility milestones as an outcome measure for stroke. Arch Phys Med Rehabil. 2003;84:977-981 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43684 | - |
dc.description.abstract | 背景與目的:急性期中風患者常伴隨有坐姿平衡能力下降及軀幹控制能力缺損的問題。過去針對任務取向式訓練之研究已指出,該種訓練方式可有效提升慢性期中風患者的平衡和行走能力,但關於任務取向式訓練應用於提升中風患者早期軀幹控制和平衡能力方面之療效,則尚缺乏文獻的探討。本篇研究的目的,即在探討為期兩週的外加式任務取向式平衡及軀幹控制訓練,對於急性期的中風病患是否安全、可耐受、且又有助提升其較晚期的姿勢控制和功能恢復。方法:本篇研究徵召十五名於台大醫院住院之中風病患,於中風天數十四天內(含),依隨機分組為實驗組(8人)和控制組(7人)。實驗組於本研究進行期間除依院內慣例接受一般院內物理治療訓練外,額外接受為期兩週的任務取向式運動訓練;控制組則於本研究進行期間除依院內慣例接受一般院內物理治療訓練外,額外接受兩週之上、下肢被動性關節活動。對兩組皆記錄每位受試者之訓練時間、每次訓練前後之生命徵象變化、及不良反應事件(adverse event);對實驗組並額外紀錄受試者之柏格自覺用力係數(Borg Rate of Perceived Exertion)。所有受試者於訓練前接受第一次臨床測試;訓練兩週後(訓練不滿兩週即出院者則於出院時)接受第二次臨床測試;並於中風天數滿三個月時再進行追蹤測試。三次的臨床測試內容皆包括肌力測試(Motricity Index, MI)、軀幹控制測試(Trunk Control Test,TCT)、中風病患姿勢控制評估量表(Postural Assessment Scale for Stroke Patients, PASS)、功能性行走分類評量(Functional Ambulation Category,FAC)、巴氏量表(Barthel Index,BI)、與修正版任金量表(modified Rankin Scale,mRS)。結果:實驗組與控制組各別於中風後7.9± 2.6天及9.4± 2.8天起開始接受總共各257± 45分鐘及267± 22分鐘的額外訓練。所有受試者皆完成本研究為期三個月的追蹤。兩組受試者在流行病學方面之特徵相似(p> .05)。實驗組接受較多的任務取向式訓練,而控制組接受較多的關節活動訓練,在特定訓練的時間上達統計上有意義的組間差異(p< .05),符合此研究設計原意。實驗組與控制組相比,並無較多的不良反應事件發生(p> .05)且受試者之生命徵象皆穩定。兩組在訓練後及中風天數滿三個月時的追蹤測試皆呈現進步(p< .05),但同時期各項測試的得分表現不具有組間差異(p> .05)。在訓練前至訓練後期間,實驗組在姿勢控制(PASS)的成效值(effect size, ES)比控制組高;在行走功能(FAC)方面實驗組已呈現統計上有意義的進步(p< .05),但控制組則尚不具有組內顯著差異的進步(p>.05)。在訓練後至追蹤期間,實驗組在肌力(MI)和日常生活自理能力(BI)的成效值比控制組高,但實驗組與控制組在姿勢控制的成效值則不具明顯差異。結論:為期兩週的外加式任務取向式平衡及軀幹控制訓練,對於急性期的中風病患而言是安全可行的。相對於外加式被動關節運動,外加式任務取向式平衡及軀幹控制訓練對於中風患者在姿勢控制能力的提升成效較佳,在訓練期間也較能促進行走能力的恢復。此療效可能與訓練項目的劑量與任務特異性(dose-related, task-specific effects)有關。未來仍需更大型的隨機臨床測試以進一步驗證此一研究結果。 | zh_TW |
dc.description.abstract | Background and Purposes: Impaired sitting balance and trunk control ability is a prevalent problem faced by patients with acute stroke. Task-oriented training has been shown effective in improving balance and ambulation ability of patients with chronic stroke, but effective clinical trials targeting at early trunk control or balance training are still scarce. The purposes of this study were to investigate whether an additional two-week, task-oriented, balance and trunk control training program started in the early phase of stroke during hospitalization would be not only safe and tolerable for patients but also effective on improving their postural control and functional recovery in the later phase. Methods: Fifteen patients admitted to the NTUH due to recent stroke (≦14 days post onset) were randomly assigned to the experimental (EXP, n= 8) or control (CON, n= 7) group. The EXP group received a two-week task-oriented training combined with the conventional physical therapy training, and the CON group received a two-week passive range of motion exercise combined with the conventional physical therapy training. The intensity of additional training in both groups was the same, which was 30 minutes a day, 5 days a week, for 2 weeks. Times spent on conventional and additional exercises and vital sign before and after additional exercise, were documented for each training session during the 2-week study intervention in both groups. For the EXP group, the Borg Rate of Perceived Exertion was documented. In addition, any adverse event during or after additional training in each group was also documented. Outcome measures, including the Motricity Index (MI), Trunk Control Test (TCT), Postural Assessment Scale for Stroke patients (PASS), Functional Ambulatory Category (FAC), Barthel Index (BI), and modified Rankin Scale (mRS) were collected at pre-training, post-training, and at 3 months after stroke. Results: The EXP and CON groups started to receive additional training program 7.9± 2.6 days and 9.4± 2.8 days post stroke onset for a total of 257± 45 minutes and 267± 22 minutes, respectively. Fifteen subjects completed all study phases according to their group assignment. The demographic characteristics at baseline were similar between groups (p> .05). As expected, subjects in the EXP group received more task-oriented training and the CON group received more range of motion exercise, which reached statistically significant differences (p< .05). The EXP group did not present more adverse events or unstable vital sign induced by additional intervention during the 2-week intervention as compared to the CON group (p> .05). There were no statistically significant differences between the groups at post-training and 3 months after stroke with regard to all the outcome measures (p> .05). Subjects in both groups significantly improved in these variables from pre-training to post-training and to the 3-month follow-up (p< .05). However, during the pre-training to post-training period, the EXP group had a larger effect size on the postural control ability (the PASS score); the EXP group also showed significant improvement in ambulation ability (the FAC) (p< .05) but the CON group did not (p> .05). During the post-training to follow-up assessments period, the EXP group had larger effect size on the muscle strength (the MI score) and the activities of daily living ability (the BI score), but the effect size of the PASS became similar between groups. Conclusions: The additional two-week, task-oriented, balance and trunk control training program combined with conventional physical therapy was safe, feasible, and tolerable in the early phase of stroke. Compared to the additional passive range of motion exercise program, this additional task-oriented training program led to more improvement on the postural control ability, and ambulation ability in the training phase. These effects may be due to dose-related, task-specific effects. Larger randomized controlled clinical trials are needed to further test these findings. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T02:25:57Z (GMT). No. of bitstreams: 1 ntu-98-R95428001-1.pdf: 1196317 bytes, checksum: b612e6e199e9fdf0bc13c9950eb50d51 (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | TABLE OF CONTENTS
口試委員會審定書…………………………………………………..… i ACKNOWLEDGEMENTS………...…………………………..………. ii CHINESE ABSTRACT…….…………………………………….……. iii ENGLISH ABSTRACT……………………………………………..…. vi INTRODUCTION……………………………………………...……….. 1 Background and Purposes…………………………………..…….... 1 METHODS…………………………………………………...………...... 17 Design……………………………………………………………….. 17 Subjects……………………………………….……………………... 17 Measures…………………………………………………………….. 19 Baseline Information………………………………………..…...19 Outcome Measures……………………………………….....….. 19 Training Programs……………………….……………….……….… 22 Conventional Physical Therapy Program…….…………….….. 23 Additional Upper/Lower Extremity PROM Exercise Program… 23 Additional Structured Task-Oriented Training Program……….. 23 Procedures…………………………….…………………………….. 25 Data Analysis and Statistics………………………………...……….. 26 RESULTS.………………………………………………...……………... 27 Subjects……………………………….……………………………... 27 Demographics……………………………………………….….. 27 Hospitalization-Related Information…...…….……………..….. 29 Intervention..………………………….………………………….….. 30 Conventional Physical Therapy Training Time…….…….....….. 30 Additional Physical Therapy Training Time…...…………....….. 31 Conventional plus Additional Physical Therapy Training Time... 32 Safety and Feasibility of the Additional Training Programs........ 32 Outcome Measure..……………………………………………….….. 34 Destination at Discharge……………...…………..…………..... 37 DISCUSSION...……………………………………………………..…... 39 Characteristics of Participants..…………………………………….. 40 Safety and Feasibility of the Additional Training Programs ...….….. 43 Outcome Changes between Pre-Training and Post-Training Tests..... 45 Outcome Changes between Post-Training and Follow-Up……......... 49 Limitations and Future Study..………....……………...…………….. 52 CONCLUSIONS.………………………………………………………... 54 REFERENCES……………………………………………….…….……. 55 APPENDICES……………………………………………………….…... 63 APPENDIX A: Subject Informed Consent……………….....………. 63 APPENDIX B: The Motricity Index….…………………….………. 70 APPENDIX C: The Trunk Control Test…………………….………. 71 APPENDIX D: The Postural Assessment Scale for Stroke Patients... 72 APPENDIX E: The Functional Ambulation Category………..…….. 74 APPENDIX F: The Barthel Index…………………..………………. 75 APPENDIX G: The modified Rankin Scale…………...……………..76 APPENDIX H: Conventional Physical Therapy Daily Note……...... 77 APPENDIX I: The Daily Exercise Note for Control Group……....... 78 APPENDIX J: The Task-Oriented Balance and Trunk Control Training Program……………………………………….….... 79 APPENDIX K: The Daily Exercise Note for Experimental Group.....80 APPENDIX L: Adverse Event Daily Note…………………….…..... 81 APPENDIX M: Procedure……………....………………………...... 82 APPENDIX N: Results of Subject Selection..……..……………...... 83 LIST OF FIGURES FIGURE 1: CONSORT chart……………..………….…………….….. 85 FIGURE 1: Diagram for change of value on the outcome measures….. 86 LIST OF TABLES TABLE 1: Baseline characteristics of the experimental and control groups.. ……………………………………………………………….. 88 TABLE 2: Hospitalization-related information of the experimental and control groups…………………………………….….……..... 89 TABLE 3: Allocation of training session and time in the experimental and control groups during the 2-week intervention period............. 90 TABLE 4: Allocation of itemized training time (minutes) of physical therapy in the experimental and control groups during the 2-week intervention period…………………………………... 91 TABLE 5: Number of adverse events during the additional intervention sessions of the 2-week period………………………..……..... 92 TABLE 6: Comparisons of outcome measures within and between groups………........................................................................... 93 TABLE 7: Change of values on the MI, PASS and BI in the experimental and control groups………........................................................ 94 | |
dc.language.iso | en | |
dc.title | 任務取向式平衡訓練對急性期中風病患姿勢控制與功能恢復之成效 | zh_TW |
dc.title | Effects of Task-Oriented Balance Training on Postural Control and Functional Recovery in Patients with Acute Stroke | en |
dc.type | Thesis | |
dc.date.schoolyear | 97-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 張權維(Chein-Wei Chang),鄭素芳(Su-Fanng Jeng),鄭建興(Jiann-Shing Jeng),邱銘章(Ming-Chang Chiu) | |
dc.subject.keyword | 急性期中風,任務取向式,平衡,姿勢控制,功能恢復, | zh_TW |
dc.subject.keyword | acute stroke,task-oriented,balance,postural control,functional recovery, | en |
dc.relation.page | 94 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2009-08-18 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-98-1.pdf 目前未授權公開取用 | 1.17 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。